Key Question Chapter Outline Psychology in Your Life

Key Question Psychology in Chapter Outline CORE CONCEPTS Your Life What Is Therapy? ▼ Paraprofessionals Do Entering Therapy Therapy for psychological Therapy, Too. The Therapeutic Relationship and the disorders takes a variety of Some studies show that the Goals of Therapy forms, but all involve some therapist‘s level of training is not Therapy in Historical and Cultural relationship focused on the main factor in therapeutic Context improving a person’s mental, effectiveness. behavioral, or social functioning. How Do Psychologists Treat ▼ Where Do Most People Psychological Disorders? Psychologists employ two Get Help? Insight Therapies main forms of treatment: the A lot of therapy is done by friends, Behavior Therapies insight therapies (focused on hairdressers, and bartenders. Cognitive–Behavioral Therapy: developing understanding of A Synthesis the problem) and the behavior Evaluating the Psychological therapies (focused on Therapies changing behavior through conditioning). How Is the Biomedical ▼ What Sort of Therapy Would Approach Used to Treat Biomedical therapies seek to You Recommend? Psychological Disorders? treat psychological disorders There is a wide range of therapeutic by changing the brain’s Drug Therapy/Psychopharmacology possibilities to discuss with a friend chemistry with drugs, its Other Medical Therapies for Mental who asks for your recommendation. circuitry with surgery, or its Disorder patterns of activity with pulses Hospitalization and the Alternatives of electricity or powerful magnetic fields. Therapies: The State of the Art USING PSYCHOLOGY TO LEARN PSYCHOLOGY: How Is Education Like Therapy? Chapter Therapies for 1313 Psychological Disorders AURA, A PETITE WOMAN in her 40s with a Lcontagious smile, speaks intently about her profession as a psychotherapist. “Yes,” she says, “Once your therapeutic practice is established, you might enjoy greater flexibil- ity, autonomy, and meaningfulness than in many other careers. But no, it’s not easy work, and it demands both an intellectual and an emotional investment. Moreover,” Laura protests, dispelling a common myth about therapy, “A therapist is not a ‘paid friend’! A therapist is a trained professional who knows the art of establishing a helping relationship and knows how to apply the knowledge of psychology to an individual struggling with problems and choices.” Laura’s orientation is in humanistic therapy, an approach aimed at helping clients see themselves clearly. Humanistic therapies are designed for individuals who seek to be more adaptive, healthy, and productive in their lives. “Early in the therapeutic relationship, my role might be somewhat parental,” Laura explains. “Perhaps my client never had the opportunity to grow up with real support. As a child, this client may have cre- ated a way to function that worked for her. But now, she needs to be an adult—not a child—and she gets pushed back into those old ways of reacting. It becomes self- sabotaging. The client feels stuck.” Laura sits quietly for a few moments, then goes 523 on. “Since I’ve been there myself, I recognize it. When the client finally trusts me enough, I point these issues out to her, and she can begin to take charge of her life in a healthier way.” Today, practicing psychotherapists may hold any of dozens of degrees and certifi- cations, choosing from scores of therapeutic techniques. For all that training, however, Laura insists that working as a therapist is not purely a science. “Therapy is also an art,” asserts Laura, “It’s experiential. We may know the skills required to be an effective therapist, like listening well. And we know the central issues, like trust between therapist and client. But these aren’t enough to make someone a good therapist. You also need personal experience and insight. You need to be able to sense what your client cannot communicate. And there’s no science for that—it’s intuitive.” But there’s still more to having a psychotherapy practice, Laura points out: “It’s not only challenging cases that are difficult! Sometimes it’s the hassles of dealing with health insurance that get to you.” Laura grins. “But when the therapeutic relationship is real, and our work together progresses, it’s very satisfying—even, sometimes, fun! Once we finally ‘get it,’ my client and I can laugh together. “I do love it. I love the intensity of it,” Laura concludes. “As a therapist, I am there for my clients—with my clients. I see them clearly. They come to me with the gift of their trust. It’s awe-inspiring. And they wouldn’t come if they didn’t have the strength and the love to keep going and keep growing.” ■ Therapy A general term for any treatment process; in psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques As Laura makes clear, therapists work at the interface between the science and aimed at dealing with mental disorders or art of helping. Her approach to therapy, as you will see in this chapter, is just coping with problems of living. one of many ways to be a therapist. Yet, despite the diversity of approaches that Laura and her colleagues bring to their work, the over- whelming majority of people who enter therapy receive significant help. Not everyone becomes a success case, of course. Some people wait too long, until their problems become intractable. Some do not end up with the right sort of therapy for their problems. And, unfortunately, many people who could benefit from therapy do not have access to it because of financial constraints. Still, the development of a wide range of effective therapies is one of the success stories in modern psychology. In this next-to-last chapter of our journey together through psychology, we begin an overview of therapy by considering what therapy is, who seeks it, what sorts of problems they bring to it, and who administers it. Here we will also see how therapeutic practices have been influenced by history and culture. In the second section of the chapter, we will consider the major types of psychological treatments currently used and how well they work. Then, in the final section, we will look at medical treatments for mental disorders, including drug therapy, psy- chosurgery, and “shock treatment.” There we will also compare hospital treatment for mental disorder with community-based treatment. As you read through this chapter, we hope you will weigh the advantages and disadvantages of each therapy. Keep in mind, too, that you may sometime be asked by a friend or rel- ative to use what you have learned here to recommend an ● Many people could benefit from some form of therapy. Most appropriate therapy. It’s even possible that you may sometime people who enter therapy receive significant help. need to select a therapist for yourself. 524 CHAPTER 13 ❚ THERAPIES FOR PSYCHOLOGICAL DISORDERS WHAT IS THERAPY? When you think of “therapy,” chances are that a stereotype pops into mind, absorbed from countless cartoons and movies: a “neurotic” patient lying on the analyst’s couch, with a bearded therapist sitting at the patient’s head, scrib- bling notes and making interpretations. In fact, this is a scene from classic Freudian psychoanalysis, which is a rarity today, although it dominated the first half of the 20th century. The reality of modern therapy differs from the old stereotype on several counts. First, most therapists don’t have their patients (or clients) lie on a couch. Second, people now seek therapeutic help for a wide range of problems besides the serious DSM-IV disorders: People also go to counselors or therapists for help in making difficult choices, dealing with academic problems, and coping with losses or unhappy relationships. And here’s a third way in which the stereotype of therapy is false: Some forms of therapy now involve as much action as they do talk and interpretation—as you will see shortly. © The New Yorker Collection 1995. Mick Stevens from cartoonbank.com. All Rights Reserved. At first, the therapeutic menu may appear to offer a bewildering list of choices, involving talk and interpretation, behavior modification, drugs, and, in some cases, even “shock treatment” or brain surgery. No matter what form therapy takes, however, there is one constant, as our Core Concept suggests: Therapy for psychological disorders takes a variety of forms, but all involve some relationship focused on improving a person’s mental, behavioral, or social functioning. In this chapter, as we examine a sample from the therapeutic universe, we will see that each form of therapy is based on different assumptions about mental disorder. Yet all involve relationships designed to change a person’s functioning in some way. Let’s begin our exploration of therapy by looking at the variety of people who enter treatment and the problems they bring with them to the therapeutic relationship. WHAT IS THERAPY? 525 Entering Therapy Why would you go into therapy? Why would anyone? Most often, people enter therapy when they have a problem that they are unable to resolve by themselves. They may seek therapy on their own initiative, or they may be advised to do so by family, friends, a physician, or a coworker. Cathy by Cathy Guisewite/Universal Press Syndicate Obviously, you don’t have to be “crazy” to seek therapy. If you do enter therapy, however, you may be called either a patient or a client. Practitioners CONNECTION CHAPTER 12 who take a biological or medical approach to treatment commonly use the term The medical model assumes that mental patient. On the other hand, client is often used by professionals who think of disorders are similar to physical diseases. psychological disorders not as mental illnesses but as problems in living (Rogers, 1951; Szasz, 1961). Access to therapy can be affected by a variety of factors.

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